No More Amputation Call

No more vascular amputations

VAS Call: “No more vascular amputations” an ethical issue and a realistic tool.

•Peripheral Arterial Disease (PAD), has a high social burden due to its prevalence, its complications (CV Acute fatal and non-fatal events, including Amputation), and its costs (superior for inpatients in its advanced stages, to those of CHD or Stroke)

•In addition, PAD will increase with the increase in life expectancy and in the aging population.

•As has already been demonstrated, PAD will extend not only high income countries (HIC) but also in low and middle income countries (LMIC ). PAD is now a world wide relevant problem.

•CV Acute fatal and non-fatal events are related to the stage of the disease.

•CLI is the most advanced stage of PAD, with a high risk of Amputation and the highest rate of death.

•Today the trend of PAD complications (acute non-fatal events, amputations and death) appears to be stable or even growing, despite the increase in expenditure from Claudication to CLI.

•On the other hand, PAD gives a positive response to simple preventive measures if approached in stages I and II (Asymptomatic or Claudication).

•Several cardiovascular events can been prevent and the PAD evolution controlled and consequently Vascular Amputations can be mostly cancelled.

•The clinical evaluation alone can diagnose PAD.

•Palpation of the foot arteries (Anterior and Posterior Tibialis) can easily lead, at least, to a suspected diagnosis to be confirmed after an ABI exam, an extremely cheap diagnostic tool.

•Population and Patient endorsement is finally an indispensable tool to obtain a long-term therapeutic efficacy. Similarly important is the dissemination of knowledge and of diagnostic suspicion in the population.

•The FeeTest, launched by VAS in 2014 during the VAS and WHO Joint Session (10th European Angiology Days) consist in a people self-examination of the feet arteries, together with a questionnaire to be self-completed (Edimburgh modify questionnaire) This can stimulate interest and doubt and will lead to an 'interaction with GPs (see FeeTest in Awareness Area).

•Make a diagnosis for PAD Patients is a due commitment and the results are sensible both in human and social as well as in economic terms.

•Preventing the deterioration of PAD is a primary ethical commitment for those who work and have responsibilities in the National Health organizations.

The VAS Call : “No more vascular amputations” is launched and consists in a coordinate collaboration at any level to:

•disseminate culture through information and education on PAD,

•make preventive measures as much simple and familiar as possible and

•obtain interest by Institutions in this area where there is a sensible lack of Equity and ethics and where the priorities and the organization in our Health Systems are highly uneconomical.